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that

is the identical person

represents --self to be; and that they have

no interest in the prosecution of this claim.

[Signatures of witnesses.]

Sworn to and subscribed before me this day of A. D. 189—, and I hereby certify that the contents of the above declaration, &c., were fully made known and explained to the applicant and witnesses before swearing, including the words —, erased, and the words -, added; and that I have no interest, direct or indirect, in the prosecution of this claim.

[L. S.]

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All the blanks in this form should be carefully filled and the requirements of the notes strictly observed.

An honorable discharge from the service in all cases is necessary.

Declarations of claimants, either for original pension or for increase of pension already granted, must be made before a court of record, or before some officer thereof having custody of its seal; said officer being fully authorized and empowered to administer and certify any oath or affirmation relating to any pension or application therefor.

The claimant's identity and loyalty must be proven by two witnesses, certified by the judicial officer to be respectable and credible, who are present and witness the signature of the declarant, and certify to his identity and loyalty under oath or affirmation.

Declarations and other papers should be as legible and as clear in statement as possible. Where any evidence is already on file in any department of the Government, a definite description of and specific reference to it will render it available in any subsequent claim.

The post-office address (naming street and number in all large cities) of the applicant, attorney, and witnesses should be embodied in or accompany every application, and all evidence in each claim; and each change of residence of said parties, while communicating with the Pension Office or the pension agents, should be stated.

Pensions are, by law, exempted from any liability on account of the obligations of the pensioners, and no lien upon them can be recognized.

All facts, testimony of which is required to establish a claim, must be proven by the affidavits of two or more credible witnesses, unless other evidence is specified.

The statements of claimants, unless duly corroborated, are not accepted as evidence. Testimony, in support of allegations made in a declaration, may be taken before any officer whose authority and signature are duly certified, and who shall disclaim any interest, direct or indirect, in the prosecution of the claim.

Persons desiring to complete claims pending at the decease of the claimants, must furnish a duly verified certificate of their authority as heirs or legal representatives.

With all claims for arrears, increase, or restoration to the rolls, the original pension certificate must be returned, or explanation of its absence must be given under oath.

To facilitate the adjudication of claims, all the requisite evidence that is available should be forwarded with the application.

U.

[3-026.]

U.

WAR OF 1812.-DECLARATION OF A WIDOW FOR PENSION UNDER ACT OF FEBRUARY 14, 1871.

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County of

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STATE OF
On this day of — A. D. one thousand eight hundred and ninety-
personally appeared before me

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of the

a court of record aged

years, a who, being duly sworn accord

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who served the full service of the United States in the war of 1812; who 2 in Captain division, at

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on the

day

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181-, and was honorably discharged at

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of

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-; that she was married under the name of

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day of there being no legal barrier to said marriage; that her said on the 18-, and that she has not remar

day of

ried since his death; that at no time during the late rebellion against the authority of the United States did she or her said husband adhere to the cause of the enemies of the Government, giving them aid or comfort, or exercise the functions of any office whatever under any authority, or pretended authority, in hostility to the United States; that she will support the Constitution of the United States; that she is not in receipt of a pension under any previous act; that she makes this declaration for the purpose of being placed on the pension roll of the United States under the provisions of the act approved February 14, 1871, and hereby constitutes and appoints, with full power of substitution and revocationof her true and lawful attorney to prosecute her claim and procure the issuance of a pension certificate to her. That her post-office address is State of and her domicile or place of abode is

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at -, persons whom I certify to be respectable and entitled to credit, and who, being by me duly sworn, say they were present and saw the claimant, sign her name (or make her mark) to the foregoing declaration; that they have every reason to believe, from the appearance of said claimant and their acquaintance with her, that she is the identical person she represents herself to be; and at no time during the late rebellion against the authority of the United States did she, or her said husband, adhere to the cause of the enemies of the Government, or give them aid or comfort; and that they have no interest in the prosecution of this claim.

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Here give place, capacity, and manner of service, and any historical events in the war in which he participated, or with which he was connected.

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By an act of Congress approved February 14, 1871, pensions at the rate of $8 per month are granted to the officers and enlisted and drafted men (both militia and volunteers) of the military and naval service of the United States in the war of 1812 who served for a period of sixty days, and to the widows of those who have died who were married prior to the treaty of peace (February 17, 1815) which terminated said war. Also to such officers and soldiers who served less than sixty days who have been personally named in any resolution of Congress for any specific service in said war.

An honorable discharge from the service in all cases is necessary.

Declarations of these claimants must be made before a court of record, or before some officer thereof having custody of its seal, said officer being fully authorized and empowered to administer and certify any oath or affirmation reiating to any pension or application therefor.

The claimant's identity and loyalty must be proven by two witnesses, certified by the judicial officer to be respectable and credible, who are present and witness the signature of the declarant, and certify to his identity and loy

Under this act three classes of claims will alty under oath or affirmation. arise:

First.-Of officers, soldiers, and sailors, who served for sixty days, who have never been pensioned for a disability incurred in the service of the United States. These will be entitled to a full pension of $8 per month from February 14, 1871. Second.-Of officers, soldiers, and sailors, who served for sixty days, but who are in receipt of a pension for disability incurred in the service of the United States. These will be entitled to an increase of their pension to $8 per month from February 14, 1871.

Third. Of widows of officers, soldiers, and sailors who served sixty days who were married to the soldier prior to the treaty of peace which terminated said war (February 17, 1815), and who have since remarried. These will not be entitled to $8 per month from February 14, 1871. If the term of service was less than sixty days, there is no claim for pension under this act, unless the person who served has been personally mentioned in a resolution of Congress for some specific service in said war; in which case he or his widow is entitled to the same benefits under its provisions as though he had served the full period of sixty days.

The declaration must recite the name, age, and residence of claimant; whether married or unmarried; that the term of service was the full period of sixty days; or that he has been mentioned in a resolution of Congress, giving date of resolution; the place and time of enlistment and discharge, and the company, regiment, brigade, and division in which he served; the places, capacity, and manner of service, and his participation in, or connection with, any historical event of the war are particularly desired to be mentioned.

The declaration must also contain the following oath:

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That I (if a widow, "That neither I nor my said husband") at no time during the late rebellion against the authority of the United States, adhered to the cause of the enemies of the Government, giving them aid or comfort, or exercised the functions of any office, under any authority, or pretended authority, in hostility to the United States, and that I will support the Constitution of the United States."

Sworn to and subscribed before me this

day of

A. D. 189-, and I

hereby certify that the contents of the above declaration were fully made [L. S.] known and explained to the applicant and witnesses before swearing, including the words erased and the words added; and that I have no interest, direct or indirect, in the prosecution of this claim.

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CLAIM OF WIDOW FOR SERVICE PENSION UNDER THE PROVISIONS OF SECTIONS 4736 TO 4740 (INCLUSIVE), REVISED STATUTES, AND THE ACT OF MARCH 9TH, 1878.

[N. B.-All the blank spaces in this form must be carefully filled up in accordance with the instructions on the back hereof, and from the best information possessed, or obtainable, by the applicant.]

STATE OF

County of day of

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and for the county and State aforesaid, (1) in the State of

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aged

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On this A. D. one thousand eight hundred and sonally appeared before me, the same being a court of record within years, a resident of who, being duly sworn according to law, declares deceased, who was the identical (3) in the com

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that she is the widow of (2)
who served under the name of (4)
pany commanded by Captain
manded by

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in the war of 1812; that her
day of
A. D.

as a (5) —
Regiment of
said husband (6)
for the term of

on or about the continued in actual service in said war for the term of (7)

ices terminated, by reason of (8)·

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at

-, on the

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She further states that the following is a full description of her said husband
She further states that she was mar-

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at the city (or town) of

day of

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on the

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in the State of

and that her name ; and she further states that (12).

died at

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and that she has not again married; and she further declares that the following have been the places of residence of herself and her said husband since the date of his discharge from the Army, viz: (14) She makes this declaration for the purpose of obtaining the pension to which she may be entitled under sections 4736 to 4740 (inclusive), Revised Statutes, and the act of March 9th, 1878, and hereby appoints her true and lawful attorney to prosecute her claim; and she further declares that she has heretofore made application for (15) and that her residence is No. street, city (or town) of State of

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-, persons whom I certify to be respectable and entitled to credit, and who, being by me duly sworn, say that they have known the said for years, respectively; that they were present and saw her sign her name (or make her mark) to the foregoing declaration; that they have every reason to believe, from the appearance of said claimant and their acquaintance with her, that she is the identical person she represents herself to be; and they further say that they are able to identify her as the person who was

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the wife of the identical (16)

who rendered the service alleged in in the regiment

the above application (in the company of Captain

of

-) by the following-named facts and circumstances, and that they have no interest in the prosecution of this claim.

in the war of

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[Signatures of witnesses.]

day of

Sworn to and subscribed before me this , A. D. 18—; and I hereby certify that the contents of the above declaration, etc., were fully made known and explained to the applicant and witnesses before swearing, including tho words erased, and the words added; and that I have no interest, direct or indirect, in the prosecution of this claim. [L. S.]

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[Official character.]

Co.

Reg't of

NOTES.

1 Here allege full name of applicant.

2 Here allege full name of soldier.

3 Here allege again the name of soldier.

4 Here allege the name under which the soldier served.

5 Here allege the rank under which the soldier served.

6 Here state "enlisted," ""volunteered," or "was drafted," as the case may be.

7 Here state the number of days or months of service rendered by the soldier; fourteen days being the shortest period for which service pension is by law allowed, unless the soldier was actually engaged in a battle. If the claim is made for battle service the blank should be so varied as to allege such service in addition to the allegation of term of service.

Here insert the words "an honorable discharge," or "death." as the case may be.

Here let a full description of soldier follow, giving age, occupation, birthplace, height, color

of hair, eyes, and complexion, and any other particulars as to description.

10 Here allege the name of the person who performed the marriage ceremony.

11 Here state the official character of the person who performed the ceremony; i.e., whether a minister of the gospel or a justice of the peace, &c.

12 Here state whether the claimant or her husband (the soldier) had been previously married; and if either had, the name of the former husband or wife should be stated; and the date and place of the death of, or divorce from, the former consort should be alleged.

13 Here insert the name of the husband on account of whose service and death the claim is made.

14 Here state all the places of residence; if in a city, giving the street and number; and from and to what dates he resided at each place.

15 If any application for bounty land or pension has previously been made, state the fact here, giving the date, and number if possible, and the act of Congress under which the claim was made; and designating whether it was a claim for bounty land or pension, and whether a warrant for the land or certificate for the pension was ever issued.

:6 Here insert the name of the soldier.

17 Here name all the facts nd circumstances which enable the witnesses to swear, from a personal knowledge, that the claimant is the widow of the identical person who rendered the service alleged in the claim.

All services rendered by the soldier in the war for which claim is made, or in any other war, with the names of officers in each service, must be given in the application.

If this blank is used, it will be useless to fill the spaces relating to the appointment of attorneys. If the service was rendered as a substitute, the name of the principal for whom the substitute served should be given.

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